Wu Jie-Ying, Liao Can, Chen Jin-Song, Xu Zun-Peng, Gu Shao-Ling, Wu Shao-Qing, Lu Yan, Xie Gui-E
Guangzhou Cord Blood Bank, Guangzhou Women and Children's Medical Center, Guangdong Province, China.
Zhongguo Shi Yan Xue Ye Xue Za Zhi. 2010 Dec;18(6):1535-41.
Umbilical cord blood (UCB) is an alternative source of hematopoietic stem cells for transplantation with success being associated with the total nucleated cell (TNC) count, CD34(+) cells and colony-forming unit-granulocyte-macrophage (CFU-GM) content infused. This study was purposed to clarify the impact of maternal and neonatal factors on hematopoietic potential of UCB product. UCB samples were screened, processed, tested and cryopreserved according to the Standard Operation Procedure (SOP) of Guangzhou cord blood bank (GZCBB). Relationship of hematopoietic cell parameters with maternal and neonatal characteristics for 4615 UCB units was analyzed retrospectively. The results showed that both collected volume (Mean ± SD: 95.23 ± 22.42 ml; Median: 91.85 ml) and initial TNC [Mean ± SD: (1.34 ± 0.49) × 10(9); Median: 1.25 × 10(9)] correlated well with postprocessed TNC [Mean ± SD: (1.21 ± 0.42) × 10(9); Median: 1.14 × 10(9); p < 0.001], CD34(+)count [Mean ± SD: (5.14 ± 4.55) × 10(6); Median: 4.08 × 10(6); p < 0.001] and CFU-GM content [Mean ± SD: (9.72 ± 8.66) × 10(5); Median: 7.53 × 10(5); p < 0.001]. As for donor factors, only infant birth weight correlated strongly with volume collected and all hematopoietic cell parameters (p < 0.001). UCB samples from bigger babies had higher collected volume, TNC, CD34(+) count and CFU-GM content (p < 0.001). Mother's age had no correlation with all the above parameters. Gestational age correlated positively with initial/postprocessed TNC (p < 0.001) and negatively with CD34(+) count (p = 0.04), but no relation with collected volume and CFU-GM content. Cesarean section produced superior volume (Mean ± SD: 97.05 ± 22.23 ml vs 92.53 ± 22.43 ml; Median: 94.08 ml vs 88.82 ml; p < 0.001), but inferior cell count than vaginal delivery (p < 0.001). Male infants had more initial volume and CD34(+) count (Mean ± SD: 96.41 ± 22.31 ml vs 93.95 ± 22.47 ml; Median: 93.27 ml vs 90.14 ml; p < 0.001); [Mean ± SD: (5.28 ± 5.04) × 10(6) vs (5.00 ± 3.94) × 10(6); Median: 4.18 × 10(6) vs 3.94 × 10(6); p < = 0.042], but lower initial and postprocessed TNC than female ones [Mean ± SD: (1.31 ± 0.50) × 10(9) vs (1.37 ± 0.47) × 10(9); Median: 1.22 × 10(9) vs 1.28 × 10(9); p < 0.001]; [Mean ± SD: (1.18 ± 0.42) × 10(9) vs (1.24 ± 0.41) × 10(9); Median: 1.10 × 10(9) vs 1.17 × 10(9); p < 0.001], while no significant difference of CFU-GM were found between male and female infants. It is concluded that these data may be helpful to optimize the UCB donor selection and improve cost efficiency of UCB bank resource. The heavier infants after vaginal delivery should be selected and large-volume units with higher TNC should be chosen at first.
脐带血(UCB)是用于移植的造血干细胞的替代来源,移植成功与否与输注的有核细胞总数(TNC)、CD34(+)细胞和集落形成单位-粒细胞-巨噬细胞(CFU-GM)含量相关。本研究旨在阐明母体和新生儿因素对脐带血产品造血潜力的影响。根据广州脐带血库(GZCBB)的标准操作程序(SOP)对脐带血样本进行筛选、处理、检测和冷冻保存。回顾性分析了4615份脐带血单位的造血细胞参数与母体和新生儿特征之间的关系。结果显示,采集量(均值±标准差:95.23±22.42 ml;中位数:91.85 ml)和初始TNC[均值±标准差:(1.34±0.49)×10⁹;中位数:1.25×10⁹]与处理后的TNC[均值±标准差:(1.21±0.42)×10⁹;中位数:1.14×10⁹;p<0.001]、CD34(+)计数[均值±标准差:(5.14±4.55)×10⁶;中位数:4.08×10⁶;p<0.001]和CFU-GM含量[均值±标准差:(9.72±8.66)×10⁵;中位数:7.53×10⁵;p<0.001]均显著相关。至于供体因素,只有婴儿出生体重与采集量和所有造血细胞参数密切相关(p<0.001)。较大婴儿的脐带血样本采集量、TNC、CD34(+)计数和CFU-GM含量更高(p<0.001)。母亲年龄与上述所有参数均无相关性。孕周与初始/处理后的TNC呈正相关(p<0.001),与CD34(+)计数呈负相关(p=0.04),但与采集量和CFU-GM含量无关。剖宫产的采集量更高(均值±标准差:97.05±22.23 ml对92.53±22.43 ml;中位数:94.08 ml对88.82 ml;p<0.001),但细胞计数低于阴道分娩(p<0.001)。男婴的初始采集量和CD34(+)计数更多(均值±标准差:96.41±22.31 ml对93.95±22.47 ml;中位数:93.27 ml对90.14 ml;p<0.001);[均值±标准差:(5.28±5.04)×10⁶对(5.00±3.94)×10⁶;中位数:4.18×10⁶对3.94×10⁶;p<=0.042],但初始和处理后的TNC低于女婴[均值±标准差:(1.31±0.50)×10⁹对(1.37±0.47)×10⁹;中位数:1.22×10⁹对1.28×10⁹;p<0.001];[均值±标准差:(1.18±0.42)×10⁹对(1.24±0.41)×10⁹;中位数:1.10×10⁹对1.17×10⁹;p<0.001],而男婴和女婴的CFU-GM无显著差异。结论是,这些数据可能有助于优化脐带血供体选择并提高脐带血库资源的成本效益。应选择阴道分娩后体重较重的婴儿,首先选择TNC较高的大容量单位。